ECE2024 Eposter Presentations Adrenal and Cardiovascular Endocrinology (155 abstracts)
Clinical utility of S-GRAS prognostic system in adrenocortical carcinomas: confirmatory results from a single-centre institutional registry
Erik Bényei 1 , Judit Tőke 1,2 , Gergely Huszty 3 , Katalin Borka 4 , Zoltán Sápi 5 , Zsuzsanna Jakab 1 , Gergely Kiss 6 , Ildiko Kalina 6 , Péter Resimann 1 , Andrea Uhlyarik 1 , Péter Igaz 1,2,7 & Miklós Tóth 1,2
1Semmelweis University, Faculty of Medicine, Department of Internal Medicine and Oncology, Budapest, Hungary; 2Healthcare Provider of European Reference Network on Rare Endocrine Conditions; 3Semmelweis University, Department of Surgery, Transplantation and Gastroenterology, Budapest, Hungary; 4Semmelweis University, Department of Pathology, Forensic and Insurance Medicine, Budapest, Hungary; 5Semmelweis University, Faculty of Medicine, Department of Pathology and Experimental Cancer Research, Budapest, Hungary; 6Semmelweis University, Faculty of Medicine, Medical Imaging Centre, Budapest, Hungary; 7Semmelweis University, Department of Endocrinology, Budapest, Hungary
Introduction: Adrenocortical carcinoma (ACC) is a rare tumor known for its diverse biological behaviour and generally poor prognosis. Recently, the S-GRAS scoring system has emerged as an accurate prognostic model, incorporating the most frequently used clinicopathological parameters: ENSAT stage, grade, resection status, age at diagnosis, and tumor symptoms. So far, this system’s efficacy has only been validated in extensive multicenter studies, proposing it as a reliable tool for predicting outcomes in ACC patients (Elhassan, 2022).
Aims: We aimed to comprehensively outline the clinicopathological characteristics of patients treated with ACC in our tertiary referral centre. We then aimed to analyse the prognostic value of the computed S-GRAS scores and compare them to prior results on patient outcomes from previous studies. Through this comprehensive demonstration, we aimed to confirm the robustness and applicability of the S-GRAS prognostic system in a single-center study.
Methods: From our ACC patient cohort of 86 patients, we analyzed data of those patients who had fully available data to calculate S-GRAS scores. 54 patients fulfilled this inclusion criteria; all were treated at our centre between January 1, 2000, and August 31, 2022. Mann-Whitney U test was used to compare patient cohort distributions, and survival correlations were analysed using Kaplan-Meier curves with log-rank tests and univariate Cox regression analyses.
Results: The distribution of our patient cohort by S-GRAS score did not differ significantly from the cohort of Elhassan et al. (2022). Among the studied characteristics in our analysis, hormone secretion (RR=2.8, P=0.002), higher ENSAT stages (III and IV) (RR=9.5 P=0.033 and RR=13.5, P=0.011), R1 and R2 resection states (RR=3.0, P=0.002 and RR=4.7, P=0.007), and a Ki67 index above 20% (RR=2.7, P=0.026) were associated with an increased risk of mortality. Higher S-GRAS scores (4-5 points and 6-9 points) were found to have a significant negative impact on overall survival (RR=9.0, P=0.005 and RR=10.9, P=0.002). The calculated hazard ratios corresponded well to those reported in the analyses of prior multicentre studies.
Conclusion: Preoperative hormone secretion, higher ENSAT stages, R1/R2 resection states, and a Ki67 index above 20%, were associated with an increased risk of mortality. The S-GRAS scoring system emerged as a powerful tool for prognosis, as confirmed by our single-center study with consistent results from a relatively modest patient cohort. Our findings reaffirm the reliability and applicability of the S-GRAS system in diverse clinical settings, even in limited size cohorts.
Ref: Elhassan YS et al. Eur J Endocrinol. 2022
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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